Eating Disorders Flashcards
What are the lifetime prevalences of anorexia nervosa, bulimia nervosa, and binge eating disorder? When is the peak period of risk for developing an eating disorder?
women: 0.9%, 1.5%, 3.5%
men: 0.3%, 0.5%, 2.0%
- mid- to late-adolescence is the peak period for developing an eating disorder
What % of youth endorse eating disorder thought patterns and behaviours?
15-47%
Which eating disorder has the highest mortality rate of any psychiatric illness? Why?
Anorexia nervosa
- 10% of people with anorexia nervosa die within 10yrs of the onset of the disorder
- 20-25 year life expectancy reduction
What is body image and why is it an important concept for eating disorders?
- how people see, think, feel, and act towards their bodies
- people with eating disorders have clinically different perceptions, feelings, thoughts and behaviours towards their body compared to those without the disorder
What are the core features of eating disorders?
- persistent disturbance of eating or eating related behaviours, resulting in alterations in consumption of food
- changed eating behaviours which impact health and functioning
List the diagnostic criteria for Anorexia Nervosa
- persists over a period of at least 3 months
- persistent behaviours that interfere with maintaining an adequate weight for health (restricting food, purging, misuse of medication, compensating for food through intense exercise)
- powerful fear of weight gain or becoming fat
- overestimations of body size
- denial of seriousness of one’s condition
List the diagnostic criteria for Bulimia Nervosa
- cycle of behaviours occur at least once a week over a period of at least 3 months
- recurring episodes of food restriction followed by binge eating
- recurring behaviours that follow bingeing (purging)
- negatively evaluates body weight and shape and tends to value these more than anything else
- experience shame about their binging and purging and may go to great lengths to hide behaviours
List the diagnostic criteria for Binge Eating Disorder
- bingeing episodes occur at least once a week for 3 months or more
- consumption of unusually large amounts of food during a short period of time (feeling out of control over what is eaten, quantity consumed, and when to stop)
- NOT followed by compensating behaviours such as excessive exercise, self-induced vomiting, or misuse of laxatives
Overeating vs bingeing
overeating = consuming more food than the body needs at a given time
Avoidant/Restrictive Food Intake Disorder (ARFID)
- starts in infancy or childhood
- avoidance of foods with certain textures or colours or particular types of food
- possibly derived from traumatic experiences with food
- nutrition and energy requirements not met
- can lead to anorexia nervosa or bulimia nervosa if untreated
Rumination Disorder
- consistent regurgitation of chewed or partially digested food
- continues over a period of at least 3 months
- swallowed food is brought up into mouth effortlessly (no gagging, nausea)
- rumination can be symptom of anorexia or bulimia
Pica
- persistent consumption of non-food items (soap, paint, paper)
- continues over a period of at least 3 months
Other Specified Feeding or Eating Disorder (OSFED)
- Atypical anorexia nervosa
- same as anorexia nervosa BUT weight is within or above “average” range for age and height - bulimia nervosa (low frequency)
- same as bulimia nervosa, BUT cycles are occur less frequently than once per week - purging disorder
- persistent purging behaviours without binge eating episodes - Night Eating Syndrome
- excessive consumption of food following and evening meal or after waking in the night
- extreme psychological distress and disrupts daily functioning
What are 3 symptoms/disorders that are not recognized by the DSM?
- Anorexia athletica (compulsive exercising)
- orthorexia
- body dysmorphic disorder
Describe Anorexia Athletica
- compulsive exercising
- over exercising to the point that fulfilling their exercise goals takes on more importance than almost anything else in their lives
- unwilling to miss a workout
- taking time off work, school, and relationships to exercise
- focussing on the challenge of exercising instead of enjoyment
- believing one’s self-worth depends on physical performance
- rarely satisfied with physical achievements
- common among athletes and olympians (controversial)
Describe Orthorexia
- food and weight related symptoms
1. eating only food regarded as “healthy”
2. relying only on “natural” products to treat illness
3. finding pleasure in eating “correctly” rather than enjoying taste and textures of food
Body Dysmorphic Disorder
- preoccupied with appearance with non-existent or slight flaws in physical appearance
- repetitive behaviours (mirror checking, skin pricking, changing clothes)
- impairs daily functioning
- can be diagnosing in conjunction with eating disorder
How is treatment administered for eating disorders?
- often multi-disciplinary: involves multiple healthcare workers - nurses, dieticians, physicians, psychologists
- multimodel: involves number of diff. therapies
What types of therapy are used?
- CBT, psychoanalysis, nutritional education, equine therapy
What 2 issues does treatment aim to address?
- physiological/somatic symptoms
2. psychological symptoms
How are physiological/somatic symptoms addressed? What is the aim?
- by normalizing eating through learning how to eat without dieting and education about the consequences and effects of eating disordered behaviours
- aim: return to healthy weight among other things (weight gain is challenging b/c people fear the idea of gaining weight)
How are psychological symptoms addressed?
- psychological therapy by focusing on the cause of one’s eating disorder behaviours and acknowledging and promoting body appreciation and acceptance
What are some problems with treatment?
- available treatment methods are heavily focused on the main eating disorders (fewer options for other clinical disorders not recognized by DSM)
- some treatment programs require specific criteria to be met (some people cannot access this)
What are the 6 risk factors for eating disorders?
- Class and Culture
- Internalization of the Ideal
- Social Media
- Sport Pressure
- Gender Identity and Sexuality
- Environmental Factors
Internalization of the Ideal
- body dissatisfaction and internalization of socialized ideals of appearance are a risk factor
- discrepancy between body shape and body ideals and actually being able to achieve these ideals is likely driving body dissatisfaction
Class and Culture
- no matter the culture, place, and space, an individual is likely to develop an eating disorder if they internalize Western cultural and class ideals of thinness and body image
Gender Identity and Sexuality
- women are more likely to be diagnosed
- gender role endorsement (extent to which an individual closely identifies with gender norms) may underly the increased rates in women
Social Media
- promotes unrealistic body images, especially when individual perceives them to be real and uses them for comparison
Sports Pressure
- emphasizing appearance, size, low-body weight and shape/build as being critical for performance can lead to preoccupation with weight and shape
Environmental Factors
- child maltreatment, parental pressure and peer pressure are environmental factors associated with eating disorders
What are some controversies in the fashion industry?
- in some countries, there are laws that ban underweight models and require labels on images that have been manipulated
- some argue this isn’t enough to change the industry, while others say it’s a step in the right direction
What are some controversies in the food industry movement?
- in Canada, there are policies to include calorie counts on restaurant menus (means to combat obesity epidemic)
- some argue this may unintentionally increase people’s preoccupation with calories
- goes against body image movement
What are the pros and cons of social media?
pros:
- provides platform for people with eating disorders to share their stories
- used to promote positive body image
cons:
- aids in the maintenance of eating-disordered behaviour
How does the Pro-and Movement have a negative effect on social media?
- involves blogs, websites, and chat forums that support eating disordered behavioural practices
- presents themselves as “educational” and are geared towards those recovering from eating disorders
how does Fitspiration have a negative effect on social media?
- although its promotes strength and empowerment over thinness, the images on the site are predominantly focused on a particular part of the body and appear to be making “sexy” poses
- promotes symptoms associated with eating disordered behaviour
What are 2 core concepts in the Positive Body Image Movement?
- body appreciation
- bodies are more than appearance, there is also function and health - building media literacy
- understanding that images in media are often manipulated and fabricated
